HIV感染者抑郁症状严重程度与阿片类药物使用之间的长期、双向关联：一项前瞻性队列研究

Q1 Psychology

Addictive Behaviors Reports Pub Date : 2025-06-06 DOI:10.1016/j.abrep.2025.100619

Alexandria Macmadu , Yu Li , Fiona Bhondoekhan , Chung-Chou H. Chang , Anees Bahji , Stephen Crystal , Kirsha S. Gordon , Robert D. Kerns , Rachel A. Vickers-Smith , E. Jennifer Edelman , Brandon D.L. Marshall

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引用次数: 0

摘要

艾滋病毒感染者（PLHIV）中阿片类药物使用与抑郁症状严重程度之间的双向关系尚不清楚。我们假设，更高的阿片类药物使用频率与随后更严重的抑郁症状有关，而更严重的抑郁症状与随后更高的阿片类药物使用频率有关。方法：我们分析了来自退伍军人老龄化队列研究（VACS）调查样本的数据，这是一个前瞻性队列，包括在8个美国退伍军人健康管理局站点接受护理的PLHIV。从2002年到2018年，我们根据研究开始和随访时自我报告的海洛因和/或处方阿片类药物使用情况，以及抑郁症状的严重程度，评估了过去一年阿片类药物的使用频率。时间滞后，广义估计方程模型用于构建阿片类药物使用频率与随后的抑郁症状严重程度之间的关联，反之亦然，调整关键的社会人口统计学和临床特征。结果在纳入2033名PLHIV患者（98%为男性）的最终调整模型中，与从未使用阿片类药物的患者相比，每月至少使用阿片类药物的患者随后的抑郁症状严重程度更大（调整比值比[aOR] = 1.44, 95% CI: 1.22,1.70），这些变量之间的关联似乎遵循剂量-反应模式。同样，与无抑郁症状严重程度的患者相比，中度抑郁症状严重程度的患者随后使用阿片类药物的频率更高（aOR = 1.38, 95% CI: 1.17,1.62）。结论：在为退伍军人hiv提供服务的环境中，可能需要加强物质使用障碍筛查、减少危害服务和阿片类药物使用障碍药物的获取；扩大获得精神卫生服务机会的战略也可能是有希望的。

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Long-term, bidirectional associations between depressive symptom severity and opioid use among people with HIV: A prospective cohort study

Background

The bidirectional relationships between opioid use and depressive symptom severity among people living with HIV (PLHIV) are poorly understood. We hypothesized that higher opioid use frequency would be associated with greater subsequent depressive symptom severity and that greater depressive symptom severity would be associated with higher subsequent opioid use frequency.

Methods

We analyzed data from the Veterans Aging Cohort Study (VACS) – survey sample, a prospective cohort including PLHIV receiving care at 8 US Veterans Health Administration sites. From 2002 to 2018, we assessed past year opioid use frequency based on self-reported heroin and/or prescription opioid use at study entry and follow-up, as well as depressive symptom severity. Time-lagged, generalized estimating equation models were used to construct estimates of the association between opioid use frequency and subsequent depressive symptom severity, and vice versa, adjusting for key sociodemographic and clinical characteristics.

Results

In final adjusted models that included 2033 PLHIV (98 % male), subsequent depressive symptom severity was greater (adjusted odds ratio [aOR] = 1.44, 95 % CI: 1.22,1.70) for those who used opioids at least monthly compared to those who never used, and the association between these variables appeared to follow a dose–response pattern. Similarly, subsequent opioid use frequency was higher (aOR = 1.38, 95 % CI: 1.17,1.62) for those with moderate depressive symptom severity compared to those with none.

Conclusions

Enhanced access to screening for substance use disorders, harm reduction services, and medications for opioid use disorder may be warranted in settings that serve veteran PLHIV; strategies expanding access to mental health services may also be promising.

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来源期刊

Addictive Behaviors Reports Medicine-Psychiatry and Mental Health

CiteScore

6.80

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Addictive Behaviors Reports is an open-access and peer reviewed online-only journal offering an interdisciplinary forum for the publication of research in addictive behaviors. The journal accepts submissions that are scientifically sound on all forms of addictive behavior (alcohol, drugs, gambling, Internet, nicotine and technology) with a primary focus on behavioral and psychosocial research. The emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. We are particularly interested in ''non-traditional'', innovative and empirically oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research. Studies that might encourage new lines of inquiry as well as scholarly commentaries on topical issues, systematic reviews, and mini reviews are also very much encouraged. We also welcome multimedia submissions that incorporate video or audio components to better display methodology or findings.